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MRSA Infection (cont.)

What Are MRSA Infection Risk Factors?

Risk factors for getting MRSA include playing contact sports, sharing towels or other personal items, having any condition that suppresses immune system function (for example, HIV, cancer, or chemotherapy), unsanitary or crowded living conditions (dormitories or military barracks), being a health care worker, and young or old age. Almost anything that leads to breaks in the skin (for example, scratches, abrasions, or punctures) will increase infection risk. MRSA carriers (people colonized by MRSA bacteria but who are not symptomatic) can pass the bacteria without knowing it. Hospitalized patients are at risk of having health care workers accidently transfer MRSA between patients. Unfortunately, hospitalized patients usually have sites (for example, IV lines, surgical incision sites) that are easily contaminated with MRSA. Consequently, direct contact with MRSA organisms on surfaces or on infected people are the highest risk factors for getting MRSA infections.

What Are MRSA Infection Symptoms and Signs?

Symptoms of MRSA infections are variable; however, pus production is often found in the infected area. Classic examples of pus-containing areas in patients are boils (pus in hair follicles), abscesses (collections of pus), carbuncles (large abscesses with pus draining), sty (pus in an eyelid gland), and impetigo (pus in blisters on the skin). Cellulitis (infection under the skin or fatty tissue) usually does not have pus but begins with small red bumps on the skin, sometimes with itching, and also may be due to MRSA. Children and adults have many of the same symptoms. Groups such as family members, close friends, children in a day care center, or members of an athletic team may develop these symptoms within a short time span. The symptoms mentioned above are most often found in CA-MRSA but can also be found in HA-MRSA. When any antibiotic therapy fails, CA- and HA-MRSA should be considered as a potential cause of infection.

Picture of a MRSA infection on the leg
Figure 1: Picture of a MRSA infection on the leg. SOURCE: CDC

HA-MRSA infections are usually suspected when the hospitalized patient develops signs of sepsis (fever, chills, low blood pressure, weakness, and mental deterioration), even if the patient is being treated with an antibiotic. CA-MRSA patients who develop sepsis or pneumonia (lung infection) need immediate hospitalization. However, hospitalized patients do not need to have a primary site of MRSA infection, only a site where MRSA can invade (invasive or serious MRSA) and proliferate (for example, any surgical site, IV site, or site of an implanted device). Consequently, symptoms of pus production or signs of sepsis in any hospitalized patient, especially those with immune compromise (for example, HIV, cancer, or the elderly) could be due to MRSA.

Consequently, the symptoms and signs of a MRSA infection in or on the skin are as follows:

  • Redness and/or rash
  • Swelling
  • Pain at the site
  • Fever or warmth at the site
  • Pus and/or draining pus
  • Some patients may have itching
  • Some patients may develop fever
  • The site may present as a sore, boil, abscess, carbuncle, cellulitis, sty or impetigo-like crusty lesions on the face or other areas
  • Antibiotic treatment not reducing symptoms
  • More serious infections may have red streaks that progress from the site
  • Ulceration with draining pus
  • Necrotizing fasciitis (rapidly progressing infection that destroys tissue under the skin)

A summary of possible symptoms of a hospital-acquired MRSA infections is as follows:

Medically Reviewed by a Doctor on 9/11/2017

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